Retreatment with mini-screws of severe recurrent crowding in a case of Class III malocclusion with a marked arch length discrepancy problem

In December 2004, Myriam H. was almost 16 years old. The appliances used for her full-banded orthodontic treatment had been removed a few months earlier and she consulted our clinic because of a complete recurrence of anterior crowding. She had brought along the X-rays that were taken for the extraction of her four un-erupted wisdom teeth the previous month. Unfortunately, these extractions could not and did not do anything to improve the crowding which occurred as soon as the appliances were removed. She was determined to undertake a re-treatment procedure. We carefully explained to her how hard it would be to correct all the over-lapped incisor teeth and the remaining bi-maxillary protrusion that persisted even though four premolars and four third molars had been extracted in a treatment program that lacked adequate anchorage preparation and precautions. Clearly we were not being asked to correct a minor imperfection but to undertake the difficult complete re-treatment of a malocclusion that was now more severe than it had been originally. But Myriam was undeterred.